Pre-Operative Analysis and Treatment Planning in Digital Implant Dentistry

This article aims to give an overview of the application of digital technologies in implant dentistry. The workflow of digital imaging, computer-aided design and computer-aided manufacturing is followed with regard to implant dentistry. In digital imaging, cone-beam computed tomography (CBCT) and optical surface scanning, including intraoral scanning and extraoral scanning of impressions or models are discussed. The advantages of direct digitization using intraoral scanners are contrasted by the lack of scientific data on the accuracy of these technologies in certain situations. CBCT is the clinical standard for three-dimensional imaging diagnostics, however, CBCT data are significantly compromised by imaging artifacts originating from dental restorations. Computer-aided design (CAD) is used for virtual implant planning with regard to anatomical structures relevant to surgical implant placement and therefore to the long-term success of dental implants or the virtual design of implant-supported restorations. The acquired digital imaging data are used to virtually design the implant-supported restorations that are used for diagnosis and backward planning as well as possibly for the production of the final restorations on implants. Computer-aided manufacturing is applied for the production of drill guides and implant-supported restorations. Additive and subtractive production technologies and available materials as well as their indications are the focus in this article. Keywords: Digital implant dentistry, optical surface scanning, intraoral scanning, CAD/CAM, virtual implant planning, guided implant surgery